Summerville at Pinellas Park, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

5487 Issued in FL

Legal business name

SUMMERVILLE AT PINELLAS PARK, LLC

Doing business as

Emeritus at Pinellas Park

Practice address

8980 49TH St
Pinellas Park, FL 33782-5336

Phone

(727) 546-4053

Fax

(727) 544-7524

NPI assigned

May 31, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Noelle Diaz

Title

Licensing Specialist

Phone

(206) 298-2909

Specialties & licenses 2

Addresses

Other names 1

• Emeritus at Pinellas Park Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252454400000",
    "number": "1225239767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 ELLIOTT AVE",
            "address_2": "SUITE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211032",
            "telephone_number": "206-298-2909",
            "fax_number": "206-301-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8980 49TH ST",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337825336",
            "telephone_number": "727-546-4053",
            "fax_number": "727-544-7524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE AT PINELLAS PARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2009-09-09",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_title_or_position": "LICENSING  SPECIALIST",
        "authorized_official_telephone_number": "206-298-2909"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "5487",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "FL",
            "license": "5487",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emeritus at Pinellas Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Duffy Su, RN
• Jennica Sublett
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• Samantha Sugarman, ARNP
• Elizabeth Leah Sukys-Rice, LCSW
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• Sunstar Village LLC
• Super Saver Pharmacy LLC (My Choice RX)

• Assisted Living Facility in Pinellas Park, FL
• Providers in Pinellas Park, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.